Tuesday, April 15, 2014

The Census Bureau, the authoritative source of health insurance data for more than three decades, is changing its annual survey so thoroughly that it will be difficult to measure the effects of President Obama’s health care law in the next report, due this fall, census officials said.

The changes are intended to improve the accuracy of the survey, being conducted this month in interviews with tens of thousands of households around the country. But the new questions are so different that the findings will not be comparable, the officials said.

An internal Census Bureau document said that the new questionnaire included a “total revision to health insurance questions” and, in a test last year, produced lower estimates of the uninsured. Thus, officials said, it will be difficult to say how much of any change is attributable to the Affordable Care Act and how much to the use of a new survey instrument.

“We are expecting much lower numbers just because of the questions and how they are asked,” said Brett J. O’Hara, chief of the health statistics branch at the Census Bureau.

I suppose they figure with all the hoopla around the new law it's better to have it be part of the chaos rather than waiting another year when it will look as though the numbers are dropping. But honestly, couldn't someone have thought of this a couple of years ago, before the law took effect?

I cannot say for sure that a conservative regime wouldn't have managed this timing better. The government is a big lumbering beast and it's often hard to control all the moving parts. But in general, conservative governments tend to use the government for political purposes more overtly --- and get away with it.

For instance, remember this slick play from the Bush admnistration?

They could have just sent the checks. But instead they first sent every taxpayer a letter taking credit for it. At taxpayers expense! This administration couldn't even get the funds legitimately necessary to educate people about Obamacare. And when they went to the private sector to ask if they'd pick up the slack the Republicans went ballistic and accused them of lawbreaking. (I won't even go into the bogus IRS scandal that continues to this day.)

The most notorious use of the government for overtly political purposes in the Bush administration was the use of the US Attorneys office to tilt election results, although that one backfired when some prosecutors decided they didn't want to risk their reputations. But it's a testament to their chutzpah that they felt so comfortable wielding power that they even tried.

I don't think the Democrats should stoop to that level of manipulation (and lawbreaking) obviously. But knowing what the other hand is doing and plan ahead for maximum results is simply good management. And I think Democrats tend to discount that skill from a political perspective and often fail to take advantage of opportunities. At the very least they should be alert to opportunities that avert political problems.

Perhaps it wasn't possible to effect this change in census questions earlier, although at the pace government moves it's hard to believe this hasn't been in the works for some time. Sure, they might have been accused of playing politics. But so what? The Republicans will accuse them of playing politics anyway --- and the Democrats would do the same if the shoe were on the other foot. The difference is that Republicans weigh the pros and cons and don't worry about the Democrats' handwringing. It's a big advantage for conservatives: they get to rail against Big Government inefficiency even as they use it for their political advantage.

And yes, the right wingers are freaking out saying this is jacking the number somehow in Obamacare's favor, which is nonsense of course. And as the Vox link above points out, most of those who follow this issue use a number of tools including Gallup which measures a large sample.

Still, this sort of thing is unhelpful:

Census officials did have at least some concerns about changing the measurement of the uninsured rate at this moment. In a memo obtained by the Times, it was described as "it is coincidental and unfortunate timing."

"Ideally," the same memo says, "the redesign would have had at least a few years to gather base line and trend data."